MWONYA MERYL ADHIAMBO2026-07-132025https://repository.tmu.ac.ke/handle/123456789/286Pharmaceutical supply chain mechanisms refer to the acquisition of essential medications in public health facilities. In the context of Kenya’s Homa Bay County, increased efficiency and effectiveness of these processes were helpful for the sustainability and reliability of healthcare performance. However, the observed frequency of stock-out incidences and compromised quality of patient care services remained relatively high. The purpose of this research was to assess the impact of pharmaceutical drug procurement on the performance of health facilities in Homa Bay County. Specific objectives were to: investigate the relationship between need identification and performance of public health facilities, Kenya; analyze the effect of requisition of drugs on performance of public hospital facilities; evaluate the effect of supplier selection on performance of public health facilities' and assess the influence of price negotiation on the performance of public health facilities in Homa Bay county. To this end, a quantitative research design was used, where data was collected through administered questionnaires from a sample of 286 respondents drawn from various public healthcare administrative staff, healthcare providers, policymakers, and patients from different healthcare facilities. Stratified random sampling was used to select a representative sample. Multivariable linear regression was used to analyze relationships. The research credibility was therefore established on the robust methods used in enhancing the validity and reliability of the study, making a significant contribution to enhancing procurement and, therefore, the delivery of healthcare. Quantitative data was described descriptively and analyzed using multivariable linear regression to examine the relationships between procurement and healthcare performance. The research analysis determined the significant causes of inefficiency in procurement, compared the effects of various tendering procedures, analyzed the sufficiency and use of budgeting in the procurement process, and established the role played by ethical practices in improving healthcare delivery. The findings indicated that need identification explained 18.3% of health facility performance (R² = 0.183, F = 13.499, p = 0.001), requisition efficiency significantly improved performance (B = 0.301, p = 0.000), supplier selection had a direct impact (R² = 0.231, F = 18.194, p = 0.000), and price negotiation factors accounted for 25% of performance variation (R² = 0.250, F = 20.118, p = 0.000). The study concluded that inefficiencies in procurement, delays in requisition, and lack of transparency in supplier selection hindered healthcare performance. It was recommended that public health facilities enhance procurement efficiency, streamline requisition processes, and adopt transparent supplier selection and negotiation practices to improve service delivery. The significance of the study lies in its potential to enhance procurement efficiency, reduce stock-out incidences, and improve healthcare service delivery in public health facilities in Homa Bay County, Kenya.enThesis